Severely Disabled People (Hansard, 14 May 1991)

§ 5. Mr. Hannam
To ask the Secretary of State for Health what arrangements will ensure severely disabled people have control over their own personal assistance arrangements under the community care proposals.

§ Mrs. Virginia Bottomley
Our guidance to local authorities emphasises that service users, including severely disabled people and their carers, should be involved as closely as possible in decisions about what services should be provided to them individually. Section 46 of the National Health Service and Community Care Act 1990 also requires that local authorities consult representatives of users and carers in preparing their community care plans.

§ Mr. Hannam
Does my hon. Friend accept that when local authorities cannot provide the personal assistance that severely disabled people need if they are to live independent lives in the community, the present practice is that those local authorities can make cash payments to allow disabled people to buy in those services—and that that should be allowed to continue? Does she recall that she and other Ministers and the Audit Commission supported that idea in principle, and will she look for a way of putting it on a statutory basis?

§ Mrs. Bottomley
As my hon. Friend is well aware, it has not been possible to find a way to break the long-standing tradition in which local authority social service departments provide services and social security departments provide financial resources. As my hon. Friend knows, I am most sympathetic to the approach that says that those who are severely disabled should feel as far as possible in control of their destiny and of the care that they receive. In our practice guidance we shall emphasise that as strongly as we can.

§ Mr. Wigley
Does the hon. Lady accept that for such disabled people to have a real choice they need consultation and representation of the sort embodied in the Disabled Persons (Services, Consultation and Representation) Act 1986? The section to which she referred does not go anything like as far as that Act in ensuring that disabled people's voices are adequately heard so as to ensure valid choice for them.

§ Mrs. Bottomley
I do not accept that. I refer the hon. Gentleman to the debate initiated by the hon. Member for Monklands, West (Mr. Clarke) in which many of these issues were discussed. Since the passage of the Disabled Persons (Services, Consultation and Representation) Act, care for and understanding of disabled people have moved forward at a great pace and the philosophy of "Does he take sugar?" is, I hope, a thing of the past. The National Health Service and Community Care Act overtakes the Disabled Persons (Services, Consultation and Representation) Act; but we shall of course keep the matter under review once the formal requirements to consult the users and the carers on plans and assessments have been implemented. The local authority associations have been given a clear commitment, as have others 141 concerned with the disabled, that we shall continue to review the matter once community care is fully implemented.

§ Mr. Alfred Morris
Is the hon. Lady aware that the fundamental issue here is one of human dignity and independent living for disabled people? How does she respond to the letter in The Times from her hon. Friend the Member for Mid-Kent (Mr. Rowe), published last Thursday, about the need to end the legal impasse? Is she aware of the widely held view among disabled people, as reported by the Spinal Injuries Association, that the Government's attitude on this issue is "patronising and ill conceived"? Will she act now to give them both choice and the fullest possible control over their own lives?

§ Mrs. Bottomley
I very much hope that all the energy and commitment of the many organisations concerned with disabled people will be transformed into working with local authorities and their community care plans. Local authorities must have those plans drawn up within the year. They have to consult users and carers in that work, and I believe that the special protected position of disabled people under the Act should be broadened to ensure that community care moves forward as fast as possible.